Advanced ovarian carcinoma that has relapsed at least 6 months after finishing a platinum based chemotherapy, in combination with carboplatin

First line treatment of locally advanced inoperable (stage IIIA or IIIB) or metastatic (stage IV) non small cell lung carcinoma, in combination with cisplatin

First line treatment of metastatic breast carcinoma after failure with an anthracycline containing adjuvant therapy, unless anthracyclines were clinically contraindicated, in combination with paclitaxel

First line treatment of locally advanced (unresectable stage II or III) or metastatic (stage IV) adenocarcinoma of the pancreas as a single agent; also indicated if patient was previously treated with 5-fluorouracil

Initially, Gemzar was produced by Eli Lilly and Company; on 5 August 2011 generic gemcitabine made by Hospira, Inc. and price has decreased

Pathophysiology

Gemcitabine is a nucleoside analogue that replaces cytidine during DNA replication, which arrests tumor growth, resulting in apoptosis

Another target is the enzyme RNR (ribonucleotide reductase); drug binds to the RNR active site and inactivates it irreversibly; if RNR is inhibited, cell cannot produce deoxyribonucleotides that are needed for cell replication and repair (Wikipedia: Gemcitabine [Accessed 1 December 2017])

For squamous cell carcinomas of the lung, cisplatin and gemcitabine showed better survival than cisplatin and pemetrexed (J Clin Oncol 2008;26:3543) - pemetrexed is now used only for non squamous non small cell lung carcinoma

This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. Click here for patient related inquiries.